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    Tissue Thiol Concentration in High-Grade Gliomas: Is There any Association Between IDH1 Mutation Presence and Tumoral Cellular Antioxidant Defense?
    (Turkish Neurosurgical Soc, 2021) Evran, Sevket; Kayhan, Ahmet; Baran, Oguz; Cevik, Serdar; Katar, Salim; Kaya, Mustafa; Sonmez, Derya
    AIM: To assess and compare the antioxidant capacities of high-grade gliomas (HGG) according to their grades and the presence of isocitrate dehydrogenase 1 (IDH1) mutation using tissue thiol level measurement. MATERIAL and METHODS: Tissue thiol concentrations were measured in 41 HGG samples and 21 healthy brain tissues obtained from autopsy procedures, which were performed within the first 4 hours of death. All samples were stored at -80 degrees C, and a thiol quantification kit was used in evaluating tissue thiol levels. The Number Cruncher Statistical System was used for statistical analyses to detect the differences between the control group and the HGG group, which was also divided into subgroups according to their grade and IDH1 mutation presence. RESULTS: The tissue thiol levels of HGGs were found to be higher than the control group (p=0.001). Although the median thiol levels of Grade 4 gliomas were higher than those of Grade 3, no statistically significant difference was noted (p=0.076). When all tumors were compared according to the IDH1 mutation presence, IDH1-negative (IDH1-) HGGs had higher thiol contents than IDH1 mutant (IDH1+) HGGs (p=0.001). The thiol levels of Grade 4 IDH1- gliomas were statistically significantly higher than of Grade 3 gliomas (p=0.023), but no statistically significant difference between the thiol levels of Grade 3 and Grade 4 IDH1+ tumors was noted (p=0.459). CONCLUSION: We have demonstrated the higher thiol concentrations of HGGs, particularly IDH1- ones. The sulfhydryl contents of gliomas as an indicator of tumoral antioxidant capacity may be responsible for the treatment resistance of IDH1- gliomas, the mechanism of which is not clear. Thiols can be a novel target for treatment, considering the unsatisfactory results of current modalities for HGGs.
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    The Use of Rotterdam CT Score for Prediction of Outcomes in Pediatric Traumatic Brain Injury Patients Admitted to Emergency Service
    (Karger, 2020) Katar, Salim; Aydin Ozturk, Pinar; Ozel, Mehmet; Arac, Songul; Evran, Sevket; Cevik, Serdar; Baran, Oguz
    Introduction: Rotterdam CT score for prediction of outcome in traumatic brain injury is widely used for patient evaluation. The data on the assessment of pediatric traumatic brain injury patients with the Rotterdam scale in our country are still limited. In this study, we aimed to evaluate the use of the Rotterdam scale on pediatric trauma patients in our country and assess its relationship with lesion type, location and severity, trauma type, and need for surgery. Methods: A total of 229 pediatric patients admitted to the emergency service due to head trauma were included in our study. Patients were evaluated in terms of age, gender, Glasgow Coma Scale (GCS), initial and follow-up Rotterdam scale scores, length of stay, presence of other traumas, seizures, antiepileptic drug use, need for surgical necessity, and final outcome. Results: A total of 229 patients were included in the study, and the mean age of the patients was 95.8 months. Of the patients, 87 (38%) were girls and 142 (62%) were boys. Regarding GCS at the time of admission, 59% (n = 135) of the patients had mild (GCS = 13-15), 30.6% (n = 70) had moderate (GCS = 9-12), and 10.5% (n = 24) had severe (GCS < 9) head trauma. The mean Rotterdam scale score was calculated as 1.51 (ranging from 1 to 3) for mild, 2.22 (ranging from 1 to 4) for moderate, and 4.33 (ranging from 2 to 6) for severe head trauma patients. Rotterdam scale score increases significantly as the degree of head injury increases (p < 0.001). Discussion: With the adequate use of GCS and cerebral computed tomography imaging, pediatric patients with a higher risk of mortality and need for surgery can be predicted. We recommend the follow-up of pediatric traumatic brain injury patients with repeated CT scans to observe alterations in Rotterdam CT scores, which may be predictive for the need for surgery and intensive care.